YKL-40, a marker of inflammation and endothelial dysfunction, is elevated in patients with type 1 diabetes and increases with levels of albuminuria.
OBJECTIVE
The inflammation marker YKL-40 is elevated in patients with type 2 diabetes and is associated with atherosclerosis and increased cardiovascular mortality. In the present study, YKL-40 levels were examined in patients with type 1 diabetes with increasing levels of albuminuria, known to be associated with an increased risk of cardiovascular disease.


METHODS
A total of 149 patients with type 1 diabetes attending Steno Diabetes Center were examined: 58 had normoalbuminuria (urinary albumin excretion rate <30 mg/24 h), 46 had persistent microalbuminuria (urinary albumin excretion rate 30-300 mg/24 h), and 45 had persistent macroalbuminuria/diabetic nephropathy (urinary albumin excretion rate >300 mg/24 h). The control group consisted of 55 healthy individuals. Groups were matched according to sex and duration of diabetes (>30 years).


RESULTS
Median levels [interquartile range] of serum YKL-40 were significantly higher in normoalbuminuria versus control (37 [29-52] vs. 53 [32-105] ng/ml, P < 0.01) and were increasing with increasing levels of albuminuria (microalbuminuria 74 [45-160] ng/ml and diabetic nephropathy 117 [68-215] ng/ml; P < 0.001 for all comparisons). YKL-40 levels correlated with the urinary albumin-to-creatinine ratio in the total group of participants (r2 = 0.25, P < 0.001). Significant but weak intercorrelations of YKL-40 were found with age, diastolic blood pressure, A1C, and serum creatinine. After adjustment for significant covariates, albuminuria was significantly associated with YKL-40 levels (P < 0.001).


CONCLUSIONS
YKL-40 levels are elevated in patients with type 1 diabetes with an independent association between increasing YKL-40 levels and increasing levels of albuminuria. The present study is the first to suggest a role of YKL-40 in the gradually progressing vascular complications in patients with type 1 diabetes.
Rathcke
Camilla Noelle
CN
Department of Endocrinology, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark. cnr@dadlnet.dk
Persson
Frederik
F
Tarnow
Lise
L
Rossing
Peter
P
Vestergaard
Henrik
H
D054392:Adipokines; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D000071451:Chitinase-3-Like Protein 1; D003922:Diabetes Mellitus, Type 1 / Q000097:blood* / Q000150:complications; D003925:Diabetic Angiopathies / Q000097:blood*; D003928:Diabetic Nephropathies / Q000097:blood; D005260:Female; D006023:Glycoproteins / Q000097:blood*; D006801:Humans; D007249:Inflammation / Q000097:blood*; D037102:Lectins; D008297:Male; D008875:Middle Aged; D012016:Reference Values
D054392:Adipokines; D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1; D006023:Glycoproteins; D037102:Lectins